10 Facts about menstruation you might not have known

THE fact is, most of us are told two things about periods – to expect one monthly throughout our childbearing age and secondly, that the most likely reason for a missed period is pregnancy. Unfortunately, especially as it relates to the former, in practicality this may not always be true, which is why obstetrician gynaecologist Dr Anna-Kay Taylor Christmas said women need to explore the wealth of knowledge available on menstruation.

“The vast majority of women will have some experience with menstruation during their lifetime. Despite that, there are still many misconceptions that both men and women have about this natural process,” Dr Taylor Christmas said.

But what are some of those misconceptions? What are some of the things that you may not know about your period? Below Dr Taylor Christmas shares 10 period facts that you may not have known.

1. Women are born with all the eggs they will ever have or make

“Unlike men who continue producing sperm throughout their lives, women have a finite number of eggs in their ovaries at birth. Every month one is released, and in the absence of fertilisation by sperm, the lining of the uterus is shed, causing a period,” Dr Taylor Christmas explained. She underscores that the eggs continue to be used up/reabsorbed until they are all depleted. This then causes the end of periods and marks the beginning of menopause (which usually happens at about age 51).

2. Periods should start by age 16

Many girls worry about when they will finally get their period and we usually reassure them even if it hasn't started in the early teenage years. If a girl has normal breast and pubic hair development and hasn't started seeing her period by age 16, then doctors will begin investigations for an underlying cause. If she doesn't have breasts, for example, then investigations start from age 14.

3. Most women do not have a strict 28-day cycle

Dr Taylor Christmas said you shouldn't worry if your cycle isn't a perfect 28 days. “This is the standard number of days that is used for the stereotypical cycle in textbooks (which many women notice when they go to see the doctor/nurse or use menstrual apps), but in reality, most women's cycles are a few days longer or shorter,” she explained.

4. They are supposed to come every month on average

The hormonal changes that lead to a period should occur in a regular monthly cycle like clockwork. If you are over 18 years and are skipping more than two to three months regularly, you should get evaluated by a gynaecologist. This is especially important if you are thinking about getting pregnant. Periods may take a little while to normalise after they have first started, so don't worry if you're under 18-years-old.

5. It's only about 50 per cent blood

Despite its appearance, menstrual flow is only about 50 per cent blood. “The rest is made up of shed the endometrial lining (from the inner wall of the uterus), cervical and vaginal cells and mucous,” Dr Taylor Christmas said.

6. Menstrual blood doesn't smell bad on its own

“The blood is clean and only obtains a scent when it is exposed to bacteria from the genital tract/skin. It may have a slightly metallic scent due to the high levels of iron in it,” Dr Taylor Christmas said. If the blood has a very bad smell, however, she said that this is abnormal and may be a sign of poor hygiene or another underlying issue like an infection that should be investigated by a doctor.

7. Implantation bleeding at the very beginning of pregnancy can mimic a light period

“Some women can miscalculate their period and mistake this for bleeding that occurs when the newly fertilised egg implants in the wall of the uterus for a period,” Dr Taylor Christmas advised. She said that when this happens, it can result in the estimated age of the pregnancy to be off by several weeks. This, she explains, may be quite significant in the management of the pregnancy, which is why doctors offer a routine dating ultrasound as early in the pregnancy as possible to avoid any confusion with incorrect dates.

8. It's safe to have sex during your period

Many people view sex during menstruation as a taboo. In fact, in some cultural and religious circles, a woman is prohibited from the same bed as her husband or banished to separate living quarters during the time of her menstrual bleeding. “Contrary to beliefs that it is unsafe or unhealthy to have sex during your period, in fact, it is perfectly safe from a health perspective and mostly may be inconvenient due to the potential mess or discomfort of cramps that may be experienced. In addition, it's the safest time of the cycle in terms of the chances of getting pregnant,” Dr Taylor Christmas said.

9. Blood loss shouldn't be heavy

“Most women lose less than 80 ml (5.5 tablespoons) of blood per cycle, with the average amount being about six to eight teaspoons. It usually seems much more than that to most women, but when actually measured, those are the volumes we get,” Dr Taylor Christmas said. She pointed out that if your periods are so heavy that you need to use two pads at a time, your pads are flooding/overflowing and messing up your clothes, or you're passing large clots in the blood, there may be something abnormal going on. As such, you should get checked by your family physician or a gynaecologist who can order a simple ultrasound to make sure all is well with your uterus and ovaries.

10. They aren't supposed to be extremely painful

Many women are taught to grin and bear the extreme menstrual pain from an early age, and unfortunately their complaints may be dismissed by family and even some health providers because after all, “periods are very painful”. Not so, says Dr Taylor Christmas. In fact, she says that pain that is so severe that interferes with normal activities around the time of menstruation and doesn't respond to simple painkillers may point to significant underlying conditions.

“This could be a sign that you may be suffering from endometriosis or uterine fibroids – and these should not be ignored. Therefore, if you are concerned about menstrual pain, keep searching until you find a health provider that takes you seriously and evaluates you properly.”

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